Search

Background and Objectives: Bisphosphonates are widely prescribed drugs whose principal capacity is inhibiting the osteoclast function. In 2003 a complication related to their administration, bisphosphonate-related osteonecrosis of the jaw (BRONJ), was described. The objectives of this study were to identify diagnosed cases of BRONJ in a third-level hospital over 8 years, evaluating the main features in relation to the disease, the bisphosphonate and the presence of local or general risk factors that could trigger the BRONJ., Methods: Patients diagnosed with BRONJ in a centre of reference for a population of 1,100,000 inhabitants were selected. Variables analysed were classified into 3 groups: patients, bisphosphonate (focusing on dose and weighting dose/potency) and osteonecrosis., Results: Seventy cases were studied -44 women and 26 men-, with a mean age of 66.8 years. Eighteen patients received bisphosphonates orally and 52, intravenously. The mean time of administration was 26.53 months. In 67.1% of the patients it was possible to identify a local trigger, with the most common being tooth extraction (48.6%). Bone exposure was present in 89.2% of the cases, while 12 patients developed BRONJ without exposed bone, with only pain and/or chronic sinus tracts. Complete resolution was achieved in 58.6% of the patients, with a mean time of control of 16.28 months., Conclusions: 25% of the BRONJ cases were related to the administration of oral bisphosphonates, especially alendronate. Zoledronic acid was the bisphosphonate that required the fewest milligrams to induce osteonecrosis. Single bone exposure was the most common clinical finding, especially in the molar mandibular region in patients with metastatic disease., (Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.)

We report the case of an 80-year-old man who developed a haematoma in the floor of the mouth after receiving alteplase in the treatment of an acute myocardial infarction. Both the treatment received and appropriate preventive measures to avoid such haematomas are described., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Objectives: Odontoma arising in the extraosseous soft tissue is extremely uncommon. Two forms of odontoma are presently recognized: peripheral odontoma and erupted odontoma. We report an erupted odontoma arising in the posterior maxilla, and discuss the main differences between both forms of clinical presentation., Study Design: Case study., Results: A 23-year-old man presented with a firm gingival mass on the left posterior maxilla, that had gradually enlarged over one year. Orthopantomography showed a dense radiopaque mass occupying the posterior portion of the left maxilla. The pathology was reported as complex odontoma., Conclusions: This is the eleventh reported case of erupted odontoma. Unlike peripheral odontoma, erupted odontoma is generally a complex odontoma, and affects older patients.

Hepatocellular carcinoma (HCC) is quite uncommon in Europe and USA, although in this last country more than 13,000 new cases are diagnosed every year. Mandibular metastases are unusual, with only 50 cases documented. In this article, we present a 54 year-old male patient with a metastasis of HCC in right mandibular body, one year after treating the primary tumor. Curettage and biopsy of the lesion was performed, followed by a profuse hemorrhage. The patient expired six months after the biopsy, with multiple metastases. We describe the different paths for hematogenic dissemination of the process.

The rhabdoid malignant tumor was individualized by Haas et al. as an independent entity within the kidney malignant neoplasms in 1981. From its histopathological characteristics, different cases of rhabdoid extra-renal tumor were documented. This aspect has been also recognized in a wide heterogeneous group of tumors (carcinoma, melanoma, mesothelioma and mesenchymal tumors). The diagnosis of extrarenal rhabdoid tumor is based on the presence of a proliferation of epithelioid cells with large nuclei, prominent nucleoli, abundant eosinophilic cytoplasm, and conspicuous cytoplasmic intermediate filaments, which compress the nuclei. In this article we present the case of a 50-year-old male patient with a malignant maxillary tumor with characteristic rhabdoid features. Its differential diagnosis will be discussed. The literature will also be reviewed.

Actinomycosis is an infectious disease that appears throught the world, in cattle and human beings. It is a chronic granulomatous and suppurative lesion, usually affecting the cervicofacial area. Definitive diagnosis, by culture or biopsy, is not always possible, so the clinician must suspect it by its clinical presentation. It is the purpose of this article to present the patients diagnosed and treated in our Department during the last 5 years, and to review the ideal therapy.